Successful treatment of parastomal varices bleeding with percutaneous N-butyl-2-cyanoacrylate glue injection.
Parastomal varices are known complication of stoma creation in patients with portal hypertension. Similar to esophageal and gastric varices, bleeding can occur and can lead to hepatic decompensation and even death. Diagnosis of parastomal bleeding may be delayed if not suspected. Established treatment for bleeding parastomal varices includes transjugular intrahepatic porto-systemic shunt creation and surgery. We report a case of a patient with carcinoma of the cervix that was complicated by a rectal stricture postradiotherapy requiring a diversion colostomy. She also had end stage chronic liver disease secondary to chronic hepatitis C infection. She presented with 3 episodes of parastomal varices bleeding that was not initially suspected and was successfully treated with 1 session of percutaneous N-butyl-2-cyanoacrylate (Histoacryl) glue injection.
Chong
Vui Heng
VH
Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam, BA. chongvuih@yahoo.co.uk
Tan
Kim Khee
KK
Sharif
Faisal
F
D003125:Colostomy / Q000009:adverse effects*; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007267:Injections; D008875:Middle Aged; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014648:Varicose Veins / Q000150:complications*
D014014:Tissue Adhesives; D004659:Enbucrilate